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Health Promotion International Advance Access published online on October 9, 2009
Health Promotion International, doi:10.1093/heapro/dap030
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© The Author (2009). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Article

Implementing a standardized community-based cardiovascular risk assessment program in 20 Ontario communities

Megan Carter1,2,*, Tina Karwalajtys6, Larry Chambers1,3,4,5, Janusz Kaczorowski6,8,9,10, Lisa Dolovich6,10,7, Tracy Gierman1,2, Dana Cross1, Stephanie Laryea6,{dagger} For the CHAP Working Group

1 Élisabeth Bruyère Research Institute, Ottawa, Ontario, Canada, 2 Institute of Population Health, 3Department of Epidemiology and Community Medicine, 4Department of Family Medicine and 5School of Nursing, University of Ottawa, Ottawa, Ontario, Canada, 6Department of Family Medicine and 7Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada 8Department of Family Practice, University of British Columbia, Vancouver, (BC), Canada, 9Primary Care & Community Research, Child & Family Research Institute (CFRI), Vancouver, British Columbia, Canada and 10Centre for Evaluation of Medicines, St Joseph's Healthcare, Hamilton, Ontario, Canada

* Corresponding author. E-mail: mcart037{at}uottawa.ca


  Abstract

The aim of the study is to describe the implementation of the Cardiovascular Health Awareness Program (CHAP) in 20 mid-sized communities across Ontario, Canada, and identify key factors in the successful multi-site delivery of a collaborative cardiovascular risk assessment and management program. Lead organizations were identified and contracted following a request for proposals. An Implementation Guide detailed steps in community mobilization and delivery of volunteer-led pharmacy-based cardiovascular risk assessment sessions. Process data were collected through final reports; a debriefing meeting; and interviews with program staff. All 20 communities successfully implemented CHAP. Overall, 99% (338/341) of family physicians agreed to receive assessment results and 89% (129/145) of pharmacies held sessions. Five hundred and seventy-seven volunteers conducted 27 358 risk assessments for 15 889 unique participants. Essential program components were consistently included, however, variations in materials, processes and support occurred. Factors in program success included: local expertise, centralized support, identification and engagement of local physician and pharmacist opinion leaders and a balance of standardization and flexibility. Monitoring delivery of a multi-community cardiovascular risk assessment program yielded key factors in program success to inform development of a sustainable and transferable model.

Key words: hypertension control; program implementation; community-based health promotion; transferability; sustainability

{dagger} The names of additional CHAP Working Group members are listed in the Acknowledgements section


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